More and more hospitals in the U.S. offer music therapy as evidence of the benefits of music in medicine stacks up
When doctors play music before and after surgery, patients have less anxiety and pain
It is no secret the uplifting effect of music, whether you like Mozart or Metallica. A growing amount of evidence also suggests that clinicians can use the power of music to help people recover from surgery and other medical procedures.
Studies have found that listening to music before surgery can reduce anxiety, and may also reduce the need for sedatives. Listening to music after surgery, and even during, may ease pain and the need for pain meds. Hospitals seem to be taking notice.
“I think more hospitals will start offering music therapy as the research foundation is growing, and there has been good research,” said Al Bumanis, a music therapist and spokesperson for the American Music Therapy Association. There are probably about a thousand hospitals, maybe fewer, that are currently offering this type of therapy in the U.S., he said.
What is music therapy?
The basic definition of music therapy is the use of music for non-musical treatment goals, Bumanis said. And technically speaking, it has to be carried out by a trained music therapist.
In a typical session, which lasts 45 minutes to an hour, a therapist plays either recorded or live music that they think the patient will like. “I ask patients if there is something that reminds them of high school,” said Leah Oswanski, a music therapist who works with cancer patients before and after surgery.
To help patients calm down, Oswanski plays music to match the rhythm of a patient’s breathing and heart rate. “After about 20 minutes, I slow the music and they slow with me,” said Oswanski, who is the director of the Jeffrey Frank Wacks Music Therapy Program at Morristown Medical Center. The program started in 2002. The effect can also work in the opposite way, where a therapist speeds up the music to help a patient who is working on rehabilitation exercises, for example, she said.
Although music therapists say the sessions are often successful, they can go awry, for example if the music is over-stimulating or brings back painful memories. But the music therapists “are pretty well trained to know what is going on if there is a sudden change in mood or something,” Bumanis said.
Bring your own playlist
Despite the growing interest in music therapy, most of the studies that have shown the benefits of music in hospital settings have not actually involved trained therapists. Instead, doctors or nurses – or even patients themselves – play recorded music, and the patient’s response is not monitored. Experts call this practice music medicine.
A new study published yesterday in The Lancet suggests, however, that even this more hands-off use of music could have numerous benefits.
Researchers analyzed 73 studies that compared outcomes after surgery between patients who listened to music, either that they played themselves or clinicians played for them, with those who either had no music or white noise.
“We have been able to put together previous small studies and we got a lot more power to show an effect,” said Catherine Meads, who studies health technology assessment at Brunel University in the United Kingdom, and one of the authors of the study.
The researchers found that patients who listened to music either before, during or after surgery had less pain, took less pain medication and were less anxious after surgery. The effects lasted more than four hours following the operation, and were greater for patients who grooved out before their surgery.
The researchers also found that patients seemed to benefit no matter what type of music they heard. But the fact is, most clinicians probably selected easy-listening music, and if patients played their own music, it would be songs they liked, Meads said.
Although it is not clear how music is helping these patients, it could be reducing their stress response and also just creating a distraction, Meads said.
“I don’t think many docs are asking patients to bring music in (for surgery) at the moment,” Meads said. “We were hoping that hospitals in the UK might put something having to do with music in the leaflet that patients get to prepare for surgery.”
“It’s great to have the music medicine piece (but) it’s even better to do one-on-one work with the patient,” Oswanski said.
There could potentially even be dangers with patients playing their own music, as can be the case with music medicine. “Even though your favorite song might be rock ‘n’ roll, you’re playing it without monitoring it so it could be too fast,” possibly increasing your heart rate and anxiety, said Joanne V. Loewy, director of the Louis Armstrong Center for Music & Medicine at Mount Sinai Beth Israel.
The beat goes on
Loewy and her colleagues are conducting a study on how patients, as well as their caregivers and doctors, respond to music therapy in the form of live music in the postoperative intensive care unit setting. “One of our aims, and what the medical community has beckoned for, are mechanisms that could create the most healing environment,” Loewy said. This could include soft music played in the key of the beeping pumps, she said.
As more and more hospitals offer music therapy, the therapists will probably work mostly with cancer and surgery departments as well as in pediatrics, said Bumanis of the American Music Therapy Association. Currently the vast majority of the approximately 6,000 music therapists in the U.S. actually work in school systems, nursing homes and psychiatric facilities, he said.
Oswanski’s music program at Morristown Medical Center partnered with the Livestrong Foundation, which funded 13 hospitals across the country to hire a music therapist. Even though the funding has now ended, most of the hospitals have decided to keep the therapists on, and some have even expanded the music therapy program, Oswanski said.
Insurance companies sometimes reimburse for music therapy depending on the condition, Oswanski said.
“The field got a lot of publicity from (Congresswoman) Gabrielle Giffords,” who was shot in the brain in 2011. “She attributes a lot of her healing to the music therapy that she received during treatment,” Oswanski said.